Biliopancreatic Diversion Surgery

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Biliopancreatic Diversion Surgery
A Biliopancreatic diversion changes the normal process of digestion by making the stomach smaller. It allows food to bypass part of the small intestine so that you absorb fewer calories. Because of the risks, this surgery is only done in people who are severely obese and who haven't been able to lose weight any other way. Severe obesity means that you have a BMI (body mass index) of 50 or higher.

Two types of Biliopancreatic Diversion surgery
Biliopancreatic diversion:
      In this surgery, part of the stomach is removed. The remaining part of the stomach is connected to the lower portion of the small intestine. This is a high-risk surgery that can cause long-term health problems, because your body has a harder time absorbing food and nutrients. People who have this surgery must take vitamin and mineral supplements for the rest of their lives, which can be expensive.
     
      Biliopancreatic diversion with duodenal switch:
A different part of the stomach is removed, which allows the surgeon to leave the pylorus, the valve that controls food drainage from the stomach, to be left intact. This is a high-risk surgery that can cause long-term health problems, because your body has a harder time absorbing food and nutrients. People who have this surgery must take vitamin and mineral supplements for the rest of their lives, which can be expensive. Another name for this surgery is duodenal switch.

Surgical Procedure:
Biliopancreatic surgery is a restrictive surgical procedure. It is restrictive in the sense that it “restricts” how much food the stomach can hold and is “malabsorptive” in that in affects how food and calories are absorbed in the bloodstream. This combination surgery has the highest success rate for amount of weight loss.
In BPD surgery, the lower two third portion of the stomach is removed. The remaining stomach is attached to the distal segment of the small intestine, the duodenum and jejunum, the small intestine is shortened therefore nutrient absorption is significantly reduced leading to weight loss. 

Advantages of Biliopancreatic Diversion surgery includes:
  • Best weight loss results of all surgeries.
  • Eating capacity is greater than any other surgeries.
  • Continue weight loss for 18-24 months post surgery.
  • Good option for revision, if other techniques have failed.
  • Improved health problems associated with severe obesity i.e. Diabetes, high blood pressure etc.
  • Improved mobility and quality of life.
Disadvantages of Biliopancreatic Diversion surgery includes:
  • Most complicated of currently available obesity surgeries.
  • Usually performed as open operation instead of laparoscopically, with associated risks.
  • Risk of death 1:200 surgeries.
  • Longer recovery time, usually 6 to 8 weeks.
  • Requires permanent lifelong changes to patient’s diet & lifestyle.
  • Risk of iron deficiency anemia and osteoporosis if supplements not taken.
  • Dumping syndrome: nausea, reflux, diarrhea can occur after ingesting high sugar foods.
  • Increased stool frequency to 2-4/day.
  • Foul flatulence and diarrhea if fatty foods eaten.

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